‘An NZNO leadership willing to face reality’ – Letter to Kai Tiaki

It was sad to see in October’s coverage of the NZNO annual general meeting that membership had dropped by 0.9 percent over the 2019/20 year, to end on 31 March at 51,643. But I was struck by chief executive Memo Musa’s comment about this to the AGM, that “the trajectory still pointed to growth”. 

As a union, we have power in numbers. So a trajectory of growth would be good news for members. It would mean more union strength to deliver for each one of us, and more resources to support nursing. Sadly, however, this doesn’t appear to be the case. 

Just six days before the AGM, on 11 September, the chief executive had emailed all members with the results of the Board by-election. The notice stated that total membership (the number of eligible voters) was now 50,418. In other words, there had been a further 2.4 percent drop the in five months from 31 March. 

NZNO won an award at the 2019 Congress of the International Council of Nurses, for having at least three quarters of New Zealand’s practising nurses as members. This was based on an NZNO membership return submitted in 2018 and the Nursing Council’s register, as at 31 March 2019. If the awards ceremony was held today, NZNO would not qualify.

The chief executive also told this year’s AGM that, “NZNO was ‘lucky’ compared to other unions, many of which were seeing a decrease or ‘stunted’ growth”. 

The day before these words appeared in the October Kai Tiaki, a headline on Stuff announced, “Covid-19 boosts NZ union membership”. According to the Stuff article, “Union members as a proportion of the workforce rose over the three months to June, to 19.8 per cent compared with 19.1 per cent in the December quarter 2019, according to Statistics New Zealand data released by the Council of Trade Unions. Union membership rose by about 12,000 to 411,000 by the end of June, from 399,000 in March.”

Musa’s account to the 2020 AGM had the story back to front. Over the two years from September 2018 up until the 2020 Board election, while other unions have been growing, NZNO membership dropped by 4.4 percent from 52,712 to 50,418. This is not a “trajectory of growth”. 

NZNO members deserve the truth. And NZNO staff – whose livelihoods depend on the number of fee-paying members – are entitled to no less. 

The fall of 2,294 members since September 2018 is the largest numerical drop over a two-year period in NZNO’s history. This is sapping our union strength, and shaving more than a million dollars off NZNO’s annual income. It should be ringing alarm bells for all our leaders and triggering urgent corrective action. To rebuild our organisation, we need a leadership willing to face reality and be held to account. 

Grant Brookes, RN

First published (slightly abridged) in Kai Tiaki Nursing New Zealand, December 2020. The resignation of NZNO chief executive was announced two days after the letter was submitted for publication.

Newtown Union Health Service – Chairperson’s report to the 2020 AGM

Newtown Union Health Service is a not-for-profit community service providing healthcare for community service card holders, low income earners, union members and their families. NUHS is community owned and has provided affordable, accessible, appropriate, quality, not-for-profit and community based primary health care in Wellington since May 1987. Established with the support of local trade unions, two seats on the NUHS Policy Board are reserved for representatives endorsed by the New Zealand Council of Trade Unions Te Kauae Kaimahi. Since 2013, I have filled one of these positions – serving for the last four years as the Policy Board Chairperson. In the interests of getting the NUHS story out more widely, it was agreed by the Policy Board that I may re-publish my report to the 2020 AGM on this blog. The entire NUHS Annual Report 2019/20 is available online here.

“He waka eke noa – We are all in this together”. The story of NUHS over the past year has been inseparable from the story of Aotearoa New Zealand, as we united against Covid-19 and for healthy communities. Although the first known infection of the SARS-CoV-2 coronavirus in this country did not occur until two thirds of the way through 2019/20, the pandemic strongly shaped our year as a whole. 

The role of NUHS staff as essential front-line health workers against the virus was recognised and accorded a higher priority. An immediate increase in Covid-19 Response and Sustainability Funding enabled NUHS to react quickly to making sure we had the tools needed to continue providing a health service while keeping patients safe. NUHS was also contracted by Tū Ora PHO to provide an Outreach Service in Strathmore and Kilbirnie, the Mobile Swabbing service for the Wellington area and to start delivering a Covid-19 Pacific Response Package for Pacific peoples.

Some differences in timing of income and expenditure relating to the Covid-19 response contributed to an end of year surplus of $257,444, against a break-even Budget. The pandemic also made the introduction of a Hardship Fund in the 2019/20 Budget, for patients experiencing financial difficulties as a result of health care costs, particularly timely. 

As the operational team under the management of Fiona Osten adopted new ways of working under changing Covid-19 alert levels, the Policy Board provided monitoring and oversight of compliance with the evolving restrictions and guidelines. A particular focus for the Policy Board, under alert levels 2 to 4, was compliance with health and safety guidelines for NUHS staff. 

The pandemic also impacted on longer-term projects. Major work to extend the life of the building at 14 Hall Avenue, due to take place this year, was not able to begin. The Policy Board was able to allocate funding, however, so that a new roof and other external remediation is expected to be completed in 2020/21, without recourse to borrowing. 

Long-term work in our wider environment was affected, as well. In 2018/19, the Government responded favourably to 38 of the 40 recommendations in the Report of the Mental Health and Addictions Inquiry, He Ara Oranga, including several with ramifications for our service. However, implementation of these recommendations this year was delayed firstly by the pandemic and then by the approach of the general election.

It was a similar story with the Health and Disability Services Review. We were fortunate to receive some early insights into this review from panel member Margaret Southwick, who spoke at our 2019 AGM. When the final report was released in June, the Government accepted the direction of travel outlined in the Review, but detail of the changes will not become clear until the new Government gets to work after the election.

Yet by pulling together, the Policy Board did achieve some long-term goals this year. Work on updating the Constitution, which began back in 2014, was finally brought to a conclusion when the new NUHS Constitution was approved at the 2019 AGM. A major change to membership criteria means that membership of the NUHS incorporated society is no longer automatic for, or limited to, enrolled patients. Under the new Constitution, membership will now be voluntary and membership applications will be considered from supporters of the service who are not enrolled patients. These changes were prompted and guided by legal advice from Oakley Moran on current best practice for incorporated societies. Processes to operationalise the new membership system were developed over the course of 2019/20 and will be implemented in time for the 2020 AGM. 

Long-proposed governance training was undertaken. And work on reviewing and updating the organisation’s strategic plan was also completed. The new NUHS Strategic Plan 2020-25, as approved by the Policy Board, is appended to this report. 

Our efforts to seek wider unity with stakeholders has also borne fruit. Joint work with Whitireia tertiary institute this year to develop online learning packages for Primary Health Care Nurses has resulted in a set of four Refugee Health Modules. Further Nurse Education Learning Modules are planned. 

Our relationship with Tū Ora Compass PHO continues to deepen, too. We have appreciated the opportunity to participate in discussions around changing the voting system for the election of PHO Board members. And our role in the Riddiford House Incorporated Society, of which NUHS is a member, has expanded to take on the secretariat function.

We continued our excellent relationship with University of Otago, Wellington medical student teaching, including being adaptable and innovative in changes prompted by the Covid-19 pandemic and lockdown. A growing relationship with Wesley Community Action bodes well for the future.

2020/21 has also been a year of individual achievements at NUHS. Serena Moran successfully completed all of the requirements laid down by the Nursing Council of New Zealand Te Kaunihera Tapuhi o Aotearoa to become our first Nurse Practitioner (NP). The requirements include a minimum of 300 hours of clinical supervision from another NP or senior doctor, which NUHS GP Dr Jonathan Kennedy was proud to provide.

Nurse Fou Etuale joined the team of Nurse Vaccinators sent to Samoa by the New Zealand Government to help with the measles outbreak. And three NUHS staff were recognised in the inaugural Primary Health Care Awards He Tohu Mauri Ora. Dianne Theobald was runner up for Practice Nurse of the Year. Pharmacist Linda Bryant won the Green Cross Health Award for Outstanding Contribution to Health while Dr Nikki Turner was runner-up for the same award. 

The composition of the Policy Board has remained largely stable in 2019/20, as it was in the previous financial year, with gradual evolutions rather than wholesale changes in our line-up. At the 2019 AGM, the Policy Board farewelled our inaugural community representative from the Massey University student body, Jacob Paterson. Fortunately, his Massey University successor elected at that meeting, Amy Palmer, has made an equally valuable contribution. 

At the end of the 2020/21 year, we were saddened but also happy to farewell community representative Ibrahim Omer, who stepped aside after being named as a list candidate for the Labour Party. We congratulate Ibrahim on his journey to become New Zealand’s first African MP, in the certain knowledge that he carries the health and wellbeing of the people in his heart. 

I acknowledge too the remaining Board members who have helped us unite this year for health – Tāngata Whenua rep Fiona Da Vanzo, union rep Sam Gribben, community reps Barbara Lambourne and Roger Shaw and Treasurer Julie Lamb. I am also grateful to Board Minute Taker Vanessa Gray and Finance Leader Giordano Rigutto, whose support has underpinned our collective achievements.

Nō reira, me maumahara tātou ki tēnei whakatauki, “Ko te toki tē tangatanga i te rā. He toki, he tāngata” So at this time, let’s all remember this saying, “We are the adze whose bindings cannot be loosened by the sun. People together grow in strength”. 

Grant Brookes, Chairperson NUHS Policy Board

‘What’s really happening in our Mental Health Unit’ – Letter to Kai Tiaki

We write in response to an article about our service in the October issue of Kai Tiaki Nursing New Zealand. Under the headline, “Acute mental health units being upgraded” (p8), it was reported that, “A new six-bed inpatient mental health facility at Wellington Hospital will be ready in 2021.” 

Unfortunately, there is nothing in that statement that is true. 

As a standard topic for media sensationalism, mental health services in Wellington sadly suffer from inaccurate reporting, on a regular basis. So we would like to take this opportunity to inform fellow health professionals, in this privileged professional forum, about what is really happening at Te Whare o Matairangi. 

Kai Tiaki New Zealand was correct to report that our 30-bed mental health inpatient unit was one of those named in August by chief ombudsman Peter Boshier as breaching the United Nations’ Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment, for our use of seclusion rooms to home patients. 

As Stuff has reported, staff had been raising these issues with senior management long before the Chief Ombudsman’s visit. In February this year, for instance, we put them in writing in a collective letter to the chief executive and board of Capital and Coast DHB and the general manager of the mental health, addictions and intellectual disabilities (MHAID) directorate. 

Our letter expressed our concerns as health professionals at the use of inappropriate rooms in our seclusion area to house patients, as well as many other concerns over the safety of staff and patients. 

Although this work has been led by the mental health union, the Public Service Association, we are collaborating closely with NZNO and we are receiving support from the Association of Salaried Medical Specialists. 

In recent meetings with the MHAID directorate leadership team, we have been encouraged by their willingness to acknowledge, and act upon our concerns. We have also met with officials at the Ministry of Health. 

Although the solutions under discussion do not include a new six-bed inpatient mental health facility at Wellington Hospital, we are hopeful that our collective action and union solidarity will yield results which address our concerns and those of Chief Ombudsman Peter Boshier. 

  • Ian Monzari, PSA delegate
  • Grant Brookes, RN

The co-editors reply: We apologise for the error in our report last month about mental health unit upgrades. Six new units for the highest needs intellectual disability and mental health patients at Capital & Coast District Health Board will in fact be attached to the current forensic intellectual disability facility at the Rātonga-Rua o Porirua mental health campus in Keneperu, not Wellington Hospital, as reported. Completion is scheduled for 2021.
An updated news story is on p8.

‘No more pokies!’ – A submission on the City Council’s Gambling Venues Policy, on behalf of Unions Wellington

Unions Wellington is the Local Affiliate Council of the New Zealand Council of Trade Unions Te Kauae Kaimahi (NZCTU), bringing together tens of thousands of union members in our city. Currently led by a committee of six members and staff from affiliated unions, we are the united voice for working people and their families in the Capital.

Our Constitutional Objects, which include promoting and protecting the economic, social, industrial, political and educational interests of working people in Wellington, led us to make a submission as part of Wellington City Council’s review of its Gambling Venues Policy.

We consulted our parent body, the NZCTU, considered the position of working people in the city and consulted with representatives of the unionised workers in health and social services who provide support to individuals and communities experiencing gambling harm.

It was great to work with the rest of the Unions Wellington committee to produce the submission, based on a Public Health approach, calling on the City Council to:

  1. Implement a sinking lid, which allows no new venues or machines in Wellington.
  2. Support the ActionStation submission (“No More Pokies in Wellington”), and specifically to implement a gambling venues policy that provides:
    ★ A ban on any new venues including TAB venues: No new pokies venues will be permitted in Wellington.
    ★ No relocations: If a venue with pokies is forced to close or voluntarily closes, the Council will not permit the pokie machines to be relocated to any venue within the Council area.
    ★ No venue mergers: Where pubs and clubs that host pokies merge, they will no longer be permitted to host pokies.

Our full submission is available at:

‘Time for NZNO to be honest’ – Message from 2020 NZNO Award Winner

Last week, Ann Simmons received a National Award for Service to NZNO at the 2020 NZNO AGM. She had prepared a short acceptance speech, but was not given the opportunity to deliver it. In recognition of a career spanning more than 50 years, I am very honoured to be able to publish Ann’s speech notes, below. 

“Nurses Unite! You Have Nothing To Lose But Your Bedpans!”

Apparently that was the catch cry of a wildcat strike of student nurses I organised in 1968 at Hutt Hospital. It was felt that after working 12 days in a row (we only had one day off in seven and 12-day stints were common) we required a day off before we went into a study day, as many of us were sleeping that day away and not learning. We did achieve this and not much later we were required to work only five days in a week – such progress! – and all for $25.00 a fortnight, in the hand.

Thank goodness for industrial progress. Thank goodness for a recognition that nurses needed professional training. Thank you, NZNA/NZNO.

On Thursday 17th September 2020, I received an Award for Service to NZNO. I was nominated by Denise Braid and the Women’s Health College and by Erin Kennedy and Lizzie Kepa-Henry on behalf of the Greater Wellington Regional Council. I’m told it is unusual for a nomination to be received for the same person from both the ‘professional’ and the ‘industrial’ side of the NZNO. I have been very flattered and my ego received a huge boost by this nomination. Thank you, everyone.

That NZNO has these two sides is a sad fact. But the history of the organisation has recently been the subject of a paper posted by Grant Brookes, and interesting reading it was. It helped me understand and put into context why the events of the recent past within the Union have happened. It also has made me come to the conclusion that it’s time for NZNO to be honest with itself.

In my time with NZNA/NZNO, I have known the organisation employ some amazing nurses as professional advisors and researchers. People like Kate Weston (there is not enough praise for this woman), Jill Clendon, Marilyn Head, Anne Brinkman, Suzanne Rolls, Hilary Graham-Smith. I have learnt so much from these outstanding professionals and from others. They have given me a base that I have used as a bottom line for all my nursing, and for some life decisions. They have been there when the Women’s Health College tackled the hard topic of Family Violence, helping and supporting us to make a difference in women’s lives. When the contentious subject of abortion law reform arrived, Womens Health College also had the support of NZNO Kaiwhakahaere Kerri Nuku to help boost our submissions for law reforms and Kerri to this day is, I believe, still involved on behalf of nurses working in this field.

The nurses I have met along the way who have shown their wisdom and compassion like Lizzy Kepa-Henry, who can always keep me humble and grounded with her work stories. Denise Braid (friend, boss and mentor) and all the wonderful women I have met through the Women’s Health College. Women in New Zealand may not know it, but they are very lucky to have you on their side. Your collective knowledge and wisdom is enormous.

Yet NZNO is not very good at using the professionals they employ or the clinicians who belong to the organisation to speak on matters of importance. Our infection control nurses have been working so hard during this Covid Pandemic but never quoted or asked to speak out. 

We hear from the CEO of the organisation and sometimes from a highly placed member of the organisation’s executive team. But we never hear from the people who are living the experience. Nor did we hear from any representative who had been elected by all the members of the NZNO, Grant Brookes for instance. The reasons for this are known to members and leave such a bitter taste in my mouth. Grant has taught me more than anyone about fighting for a cause. Fighting with passion, with logic, with facts, with courage. Being true to yourself and holding true to the values that underpin your life path. Thank you Grant, as a leader, as a fellow nurse and as a friend. 

We are again negotiating the DHB MECA. This is happening at a time when there is unrest and probably distrust in the industrial side of this organisation. I have recently been working with nurses from PHOs. Most didn’t even know there was a strike last week for their MECA agreement! 

In a traditional sense, it could be argued NZNO is not a Union. It has some components of a Union but at its heart, in its core, it is not. This is in spite of employing amazing people, my experience being Wellington based but not exclusively, like Georgia Choveaux (resigned), Laura Thomas, Danielle Davies, Deb Chappell (retired).

Then there are members, the people who have taught me about the importance of the collective, of justice and fairness. Erin Kennedy, one of the bravest comrades I have ever known, Simon Bayliss, Anne Daniels, Katrina Hopkinson, Cheryl Hanham, Jenny Kendall, Annie McCabe, Al Dietschin, Freya Albertine-Head. And definitely many more. Many of whom have resigned as delegates or left the organisation altogether. The loss of these people leaves a gaping hole in the collective knowledge of the Union.

NZNO, thank you for the award. My hope is that what I now see as an identity crisis will be resolved. Nurses in New Zealand need our professionalism to be recognised and enhanced. We have a Chief Nurse but she/he is not part of this, at least not visibly. Look again at the Covid Crisis I haven’t heard a thing about the Chief Nurse, even though Nurses are at the core of the care. That is a disconnect that needs addressing.

Nurses need someone to fight for their working conditions and their wages. This means brave people to stand and fight against massive organisations such as DHBs, Aged Care Facilities, large medical companies, powerful Iwi health providers and the Government (whatever its colour)

This is not a fight for the faint hearted or for an organisation whose roots are firmly planted within a bed of compliance and complacency – of the old era.

My hope is that NZNO decides what it is, a Union with the balls to fight for its members or an organisation that supports and encourages professionalism, working more with the Chief Nurse and her/his office and with the NZ Nursing Council.

My opinion is that the time to try and be both has passed. So NZNO, as the song from The Hitchhiker’s Guide to the Galaxy goes: “So long and thanks for all the fish, so sad it has to come to this.”

Ann Simmons, RN RM (mostly retired and Proud to Nurse)
• Past Chair and member Greater Wellington Regional Council NZNO
• Past Chair and member of national team Women’s Health (section) College NZNO
• Past Union delegate NZNO